By NAN
The Caesarean Section (CS) option in child delivery is becoming
popular among Nigerian women, a survey by our correspondents reveals.
Respondents told NAN in the survey across some South West states and
Kwara that the increasing popularity of the procedure was hinged on
factors ranging from medical reasons to social considerations as well as
unethical motive to make profit.
Dr Ijarotimi Omotade, a Senior Lecturer in the Department of
Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University
Teaching Hospital, Ile-Ife, said CS could be justified whenever it was
deemed that the life of the mother or foetus could be in jeopardy if
vaginal delivery was allowed.
Omotade, however, said the CS rate was on the increase worldwide and
remains a cause for concern considering the risks associated with the
procedure.
According to her, the risks include but not limited to maternal
death, bleeding, dangerous clot formation in blood vessels, infection
and anaesthetic complications.
She said as beneficial as CS is , there are risks involved with it just like other surgical operations.
The expert maintained that the procedure should only be done when medically indicated.
According to Omotade, some indications for CS include when the
passage (pelvis) is too narrow for the passenger (fetus), when the
placenta or tumour is blocking the passage and when the womb (uterus) is
in danger of a rupture.
Omotade, however, said apart from the cited indications, many mothers
in the country now willingly demand for CS, hoping to escape the
excruciating pains of labour.
” Mothers are now also requesting caesarean section because they want to preserve the tone of the perineum and vagina.
” Mothers, who want their babies delivered on a particular day like
their birthdays, husband’s birthday, wedding anniversary, special
occasions like New Year day, Christmas or other religious occasions are
not left out of social factors,’’ she said.
Similarly, Prof Ernest Orji, the Head of Department of Obstetrics and
Gynaecology at OAU, Ile-Ife, said majority of pregnant women now
request for CS because they do not want to pass through labour pains.
Some, he said, also prefer to have their babies on special days to mark their wedding or birthday anniversaries.
He said the trend had changed from the past when women were afraid of
CS, adding that the procedure was now attractive with the availability
of professionals and modern equipment for successful surgery.
But Dr Modupe Lawal, a gynaecologist at Ladoke Akintola University
Teaching Hospital, Ogbomoso, said CS delivery was on the rise in Nigeria
because doctors make more money from the procedure than normal
delivery.
According to Lawal, what most private hospitals charge for CS is higher than normal delivery.
Another practitioner, Dr Adewunmi Alayaki, however, said it would be
unfair to believe that doctors who opt for CS were after monetary
benefits.
Alayaki, the Head of Surgery Department, State Hospital, Ilaro, Ogun,
told NAN that a doctor’s first and paramount responsibility was to save
lives.
According to him, several factors could be responsible for the choice of CS by any pregnant woman.
Some of the factors, according to him, are maternal factors, fetal factor and materno-fetal factors.
Others factors, he said, are age, body formation (short-statured woman), contracted pelvic and previous surgeries.
“When we look at it in the long run, it is what we have in the
society and some of the conditions that will make a doctor opt for CS.
“When we talk of economic gains to doctors, are we talking of doctors
who work in public or private sector because for a doctor who works for
government, the money is not going into his pocket,” he said.
On how popular the procedure is, Alayaki said: ” Times are changing
and a lot of women are more enlightened now, some of them even request
for it.’’
When NAN spoke with some expectant mothers, some of them expressed
reservations about the procedure while some were positively disposed to
it.
Mr Dele Hundeyin, a father of two, said his wife gave birth to his two daughters through CS.
“We have good doctors in government hospitals who take on this
procedure and are good at what they do while their fees aren’t too
exorbitant.
” It also saves a lot of time and the agony my wife would have to
pass through. So, I think it’s far better than the Hebrew delivery,”
Hundeyin added.
A gynaecologist, Dr Akinola Oladeji, expressed the belief that the
increase in rate of CS had been due in part to fall out of emergency
cases.
“A lot of people go to sub standard health facilities or mission
houses and by the time they are coming to the hospital, they already
have at least one indication for emergency caesarean section.
“Another reason for the increase is due to economic factor in that
some medical practitioner encourage it because of the profit to be made;
it’s more expensive than normal delivery.
“In our hospital, the cost of a C-Section goes for about N250,000 to N300,000 and for multiple births, it is more.
“ We have up to four C-sections in a month in this facility,” he said.
He also confirmed that the elite sometimes request for CS to avoid labour pains.
A middle-aged petty trader, Mrs Florence Adeyemi, who is a mother of
three teenagers, said she would not refuse a CS if she were to be
pregnant with a fourth child.
“The major reasons for refusal of a caesarean section is fear of
death during surgery, but that fear has since been laid to rest when I
saw my friends who have undergone a C- section and came out well.
“There is enough awareness now of the benefits of a C-section in preserving the lives of mother and child,” she said.
A 26-year-old pregnant woman said that she was planning on getting a C-section so as to decide the birthday of her child.
“It is our first child and my husband and I have decided we want the
birthday to coincide with our wedding anniversary,” the respondent, who
refused to disclose her name said.
Dr Ismaila Busari, the Ondo State Chairman of the National
Association of Government General Medical and Dental Practitioners, told
NAN in Akure that CS offers mothers laxity to reject labour pains.
“She can fix any date which will be convenient instead of going through labour pains with its contractions.
“ Normal delivery might also come with vaginal tears which can never happen with CS.
“The baby doesn’t pass through the vagina with this process; it is cut out through the stomach.
“ CS usually also saves the lives of both mother and child when the
labour lasts for a very long time without any progress, even when the
labour is induced,” he said.
He, however, said that CS has many disadvantages, including issues
such as cutting of the uterus which could result in cutting the blood
vessels accidentally.
According to him, the bleeding that occurs in CS is also usually much more than that of normal delivery.
He said that the patient might need blood transfusion due to blood loss, adding that this also has its own disadvantage.
Busari said that blood transfusion might lead to infections and diseases such as HIV and hepatitis.
“ Even when the blood is screened, the disease or infection might be
in the window period and might not show up during screening,’’ he said.
“Also, after CS, the mother passes through pain and stress due to the cut made to the stomach.
“ It varies, but the pain might last for months and in some cases will affect the mother’s daily activities.
“Infection of the cut from the operation can also occur if the cut is not treated or cleaned adequately.
“If the person is diabetic, then it won’t heal as fast as someone without diabetes,” he added.
Inspite of the increasing popularity of the procedure, it is still unappealing to some women.
A petty trader, who simply gave her name as Mrs Adebayo, said that having a CS was against her religious beliefs.
According to her, it is a sin for a Christian to choose the procedure.
A lecturer also expressed satisfaction with vaginal delivery, saying “
I like to experience what it means to bring forth a child by yourself.
“ The pain you experience is one of the joys of motherhood.
“Cesarean Section is a not for me and the pain of vaginal birth
besides is just for that moment compared to the lingering pain you
experience after the CS,’’ the academic, who also craved anonymity,
said.
The Chief Medical Director of Ekiti State University Teaching
Hospital, Ado-Ekiti, Dr Kolawole Ogundipe, said it had always been
difficult convincing some pregnant mothers to go for CS in the state.
He said this was inspite of the explanations on the risks of rejecting the procedure.
But the state Commissioner for Health, Dr Olurotimi Ojo, said
hospitals in the state were currently being equipped with the right type
of facilities and personnel, saying pregnant women and their families
had nothing to fear in whatever circumstances.
An Ilorin-based matron, Mrs Saratu Bello, also said many had died for rejecting the procedure in Kwara.
“Giving birth through CS is not a death sentence and the earlier expectant mothers realised this the better for them.
“’They should know that before medical personnel decide to carry out CS
on any pregnant woman, it is to save the life of either the mother or
child or both of them.
“But when you want to remain adamant that you must give birth only
through vaginal delivery, caution needs to be taken,” Bello said.
The matron said she was compelled to speak out on the development when
expectant mothers began to pray against undergoing the procedure during
ante-natal sessions.
“I became surprised that it is now like a norm because they (pregnant women) now pray against it during ante-natal sessions.
“What they say is that they want to deliver like the Hebrew women, so, I
know it’s a religious belief which has cost a lot of women their lives
and needs to be tackled.
“That compelled me to see it as a point of duty to educate them more on
the need for them to allow things take its due course,” the matron said.
Bello said it was surprising that some Nigerians had continued to live
in the past regarding CS while some expectant mothers eagerly opt for it
in other countries.
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